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Time In: AAA am <br /> Time Out: 8:59 am <br /> San Joaquin County <br /> z Environmental Health Department <br /> a <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> K , Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> Mobile Food Facility Official Inspection Report <br /> Name of Facility: KEILANIS SHAVE ICE#4LK1202 Date: 12/30/2015 <br /> Address: 4625 DUNCAN RD, LINDEN 95236 <br /> Owner/Operator: KEILANIS SHAVE ICE COMPANY LLC Telephone: (209)887-3507 <br /> Program Element: 1633- FOOD VEHICLE/CART(LTD FOOD PREP) <br /> Inspection Type: ROUTINE INSPECTION -Operating Permit <br /> VIOLATIONS AND CORRECTIVE ACTIONS <br /> Items listed on this report as violations do not meet the requirements set forth in the California Health and Safety Code commencing with section 7; <br /> 113700.All violations must be corrected within specified timeframe. Violations that are classified as"MAJOR"pose an immediate threat to public health <br /> and have the potential to cause foodbome illness.All major violations must be corrected immediateN.Non-compliance may warrant immediate closure of <br /> the food facility. <br /> #1 Demonstration of Knowledge <br /> OBSERVATIONS: Food handler cards are not on site. Maintain a copy on site at all times. <br /> CALCODE DESCRIPTION:All food employees shall have adequate knowledge of and be trained in food safety as it relates to their <br /> assigned duties. (113947)Food facilities that prepare, handle or serve non-prepackaged potentially hazardous food, shall have an <br /> employee who has passed an approved food safety certification examination. (113947-113947.1)Any food handler hired after June 1, <br /> 2011 shall obtain a Food Handler Card within 30 days(113948). <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: Lester Miller Expiration Date:January 14,2020 <br /> Warewash Chlorine(CO: ppm Heat: -F WaterfHot Water Ware Sink Temp: -F <br /> Quaternary Ammonia(QA): ppm - Hand Sink Temp: 100°F <br /> FOOD ITEM—LOCATION --TEMP°F--COMMENTS <br /> No Temperature Data Collected <br /> NOTES <br /> -Previous report on site <br /> Ok to issue permit for 2016. <br /> The person in charge is responsible for ensuring that the above mentioned facility is in compliance with all applicable sections of the California Health and <br /> Safety Code.If a reinspection is\required,fees will be assessed at the current hourly rate. <br /> Received by: Name and Title: Lester Miller, Owner <br /> EH Specialist: LEYNA HUYNH Phone: (209)468-3446 <br /> FA0022594 PRO539505 SCO01 12/302015 <br /> EHO 16-23 Rev.06130115 Page 1 of 1 Mobile Food Fadlity OIR <br />